Golisano Children's Hospital / Pediatric Behavioral Health & Wellness / Child and Adolescent Partial Hospitalization Service / Patient Forms & Resources Patient Forms & Resources We have provided some patient documents and tools below. Please contact us if you have any questions or you would like to request additional information. Patient Documents and Tools Safety Plan Diary Card Points Sheet Goals Emotional Rating Scale Spanish Resources CAPHS Consent for Evaluation & Treatment CAPHS Behavioral Agreement CAPHS Diary Card CAPHS Parent Assessment of Care Survey Provider Resources Referral Form for Outpatient Providers